Amanda Lee Groome
Nurse Practitioner - Gerontology Nurse Practitioner - Primary Care
255 Enterprise Blvd Suite 101
Greenville
, South Carolina 29615-6300
Amanda Lee Groome
Nurse Practitioner - Gerontology Nurse Practitioner - Primary Care
255 Enterprise Blvd Suite 101
Greenville
, South Carolina 29615-6300
(864) 797-6328
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About
Features
Specialties
- Nurse Practitioner - Gerontology
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Amanda Lee Groome
- 1 Independence Pt Suite 212
- Greenville, SC
- Zip : 29615-4545
- Phone : (864) 797-6328
Second Address
- Amanda Lee Groome
- 255 Enterprise Blvd Suite 101
- Greenville, SC
- Zip : 29615-6300
- Fax : (864) 454-8125
- Phone : (864) 454-8120
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LG0600X | Nurse Practitioner - Gerontology | 19644 | SC |
| Y | 363LP2300X | Nurse Practitioner - Primary Care | 19644 | SC |
National Provider Identifier
| NPI | 1013217850 |
|---|---|
| Provider Name | Amanda Lee Groome |
| First Address | Greenville, SC 29615-4545 |
| Second Address | Greenville, SC 29615-6300 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/10/2010 |
| Last Update Date | 30/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| NP3381 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.